Role of piperacillin in surgical prophylaxis of genitourinary infections.

One hundred sixty-five men and women undergoing open or transurethral urologic surgery participated in a study designed to compare the prophylactic efficacy and safety of piperacillin with those of cefotaxime when administered perioperatively. The piperacillin-treated group received 2 Gm one hour before surgery and 2 Gm three hours later, and the cefotaxime-treated group was administered 1 Gm on the same schedule. In 9 per cent of the piperacillin-treated patients and in 11 per cent of the cefotaxime-treated patients postoperative urinary tract infections developed, although no patient in either group had sepsis. The most frequently isolated pathogens were Escherichia coli and Enterococcus sp. As expected, the females in both surgical groups had a greater incidence of postoperative infections than did the males. No significant drug-related clinical reactions or changes in the results of the laboratory tests were encountered in either treatment group. Thus, a two-dose perioperative prophylactic regimen of piperacillin was as safe and as effective as a two-dose regimen of cefotaxime in preventing postoperative urinary tract infections or sepsis in these patients.